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地氟醚与丙泊酚在主动脉瓣置换手术中的应用比较:肾保护作用的差异:一项探索性及提出假设的研究

Comparison of the Use of Desflurane vs. Propofol in Aortic Valve Replacement Surgery: Differences in Nephroprotection: An Explorative and Hypothesis-Generating Study.

作者信息

Guerrero Orriach Jose Luis, Malo-Manso Alfredo, Nuñez Galo Mercedes, Bellido Estevez Inmaculada, Ruiz Salas Amalio, Cruz Mañas Jose, Garrido-Sanchez Lourdes, Gonzalez-Alvarez Laura

机构信息

Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29010 Malaga, Spain.

Department of Anesthesiology, Virgen de la Victoria University Hospital, 29010 Malaga, Spain.

出版信息

Life (Basel). 2022 Jul 31;12(8):1172. doi: 10.3390/life12081172.

Abstract

: The cardioprotective effect of halogenated drugs in cardiac surgery has been the subject of several studies. However, there is scarcity of data on their potential nephroprotective effects. Aortic valve replacement and coronary revascularization are the most frequent cardiac surgery procedures. The objective of this explorative study was to examine the effect of desflurane vs. propofol on renal function, when administered in aortic valve replacement surgery, including the extracorporeal circulation period. : A quasi-experimental prospective study was performed in 60 patients, who were allocated to receive either desflurane or propofol intraoperatively during aortic valve replacement surgery. As a hypnotic, group 1 received propofol, whereas group 2 received desflurane. Markers of renal function and level of cardiac preservation were determined based on biochemical parameters (troponin I, NTProBNP). : In the propofol group, there were significant variations between postoperative values of urinary NGAL and creatinine and baseline values. In contrast, no variations were found in the desflurane group in terms of hemodynamic parameters and myocardial damage. : The use of propofol vs. desflurane during aortic valve replacement surgery is associated with a decrease in renal function.

摘要

卤化药物在心脏手术中的心脏保护作用已成为多项研究的主题。然而,关于其潜在肾保护作用的数据却很匮乏。主动脉瓣置换术和冠状动脉血运重建是最常见的心脏手术。这项探索性研究的目的是在主动脉瓣置换手术(包括体外循环期)中使用时,研究地氟烷与丙泊酚对肾功能的影响。

对60例患者进行了一项准实验性前瞻性研究,这些患者在主动脉瓣置换手术期间被分配接受术中地氟烷或丙泊酚。作为催眠药,第1组接受丙泊酚,而第2组接受地氟烷。根据生化参数(肌钙蛋白I、NTProBNP)确定肾功能标志物和心脏保护水平。

在丙泊酚组中,术后尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和肌酐值与基线值之间存在显著差异。相比之下,地氟烷组在血流动力学参数和心肌损伤方面未发现差异。

在主动脉瓣置换手术中使用丙泊酚与地氟烷相比,会导致肾功能下降。

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